Aim

To assess the prevalence of the markers of atherosclerosis and arterial stiffness in patients with treated arterial hypertension and type 2 diabetes mellitus.

Material and methods

We recruited 80 patients with arterial hypertension and type 2 diabetes. Arterial stiffness was evaluated by applanation tonometry. Arterial stiffness gradient was calculated as a ratio between cfPWV/crPWV, and its elevation ≥1 was considered as arterial stiffness mismatch. Subclinical arterial damage was assessed by ankle-brachial index (ABI) and cardio-ankle vascular index (CAVI). ABI <0.9 was considered as a marker of subclinical atherosclerosis and ABI>1.3 as a marker of non-compressible arteries. CAVI >9,0 was interpreted as elevated stiffness.

Results

Increased CAVI (≥9.0) and decreased ABI (<0.9) were found in 48% and 14% of patients, respectively. Vascular age exceeded biological age by 5 to 20 years in 15% of patients. Patients with elevated CAVI were older, had higher vascular age, cfPWV and more prominent loss of arterial stiffness gradient. CAVI correlated with age (r=0.49), vascular age (r=0.90), cfPWV (r=0.36), augmentation pressure (r=0.35), albuminuria (r=-0.40), total cholesterol (r=-0.28), smoking (r=-0.27), arterial stiffness gradient (r=-0.40) and PP amplification (r=-0.33). Age was the only significant predictor of CAVI increase (β=0.75, р=0.006). Abnormal ABI was associated with smoking, more frequent treatment with insulin, a longer duration of diabetes, higher serum creatinine and arterial stiffness gradient. There were no significant predictors of ABI increase.

Conclusion

Increased CAVI is highly prevalent in patients with type 2 diabetes mellitus and arterial hypertension, while impairment of ABI is less frequent. CAVI increase and ABI decrease are associated with arterial stiffness mismatch between aorta and brachial arteries.